RGB measurements as a novel objective diagnostic test for otitis media with effusion

Conclusions: This study revealed a significant correlation between red-green-blue (RGB) values of tympanic membrane (TM) images and the presence of effusion in the middle ear. These results confirm that endoscopic RGB evaluation is a rapid and non-invasive procedure yielding objective results. Objective: To investigate, in cases of otitis media with effusion (OME), the correlation of the TM color changes with the presence and viscosity of the effusion in the middle ear. Methods: Endoscopic images of the TMs of 52 patients (group 1) and 52 healthy controls (group 2) were taken during their otologic examinations. RGB values of particular points were measured on the TM images of both groups. Additionally, in group 1 the viscosity of each effusion taken by paracentesis during surgery was also measured intraoperatively with a viscometer. Patients with viscosity values lower and higher than 450 cP (centipoise) were subdivided into groups 1a and 1b, respectively. Results: Study and control groups were comparable regarding the number of patients and their mean ages (p > 0.05). Statistically significant differences were found in RGB values of the TM between groups 1 and 2, but not between groups 1a and 1b.     

Neuropsychological predictors of self-neglect in cognitively impaired older people who live alone.

OBJECTIVE: The authors examined the accuracy of certain neuropsychological tests in the prediction of harm resulting from self-neglect in cognitively impaired seniors who lived alone. METHODS: The study included 130 participants, aged 65 and older, who scored less than 131 on the Dementia Rating Scale. Neuropsychological tests were administered at baseline, resulting in eight predictive scores. Informants and primary care physicians provided information about harm that occurred to the participants during the 18-month prospective follow up. An incident was defined as harmful if it occurred as the result of self-neglect or disorientation and resulted in physical injury or property loss or damage and required emergency interventions. Proportional hazard regression analysis was conducted to examine the predictive relationship between the eight neuropsychological tests and time to incident harm with age, sex, education, the Charlson Comorbidity Index, and the Mini-Mental State Examination included in the model as covariates. RESULTS: Twenty-seven participants experienced harm during the 18-month follow-up period. A proportional hazards model indicated that three neuropsychological tests, which measured recognition memory, executive functioning, and conceptualization, were independent risk factors for harm. CONCLUSIONS: These findings provide insight into why harm occurred in these cognitively impaired elders who lived alone. They also support the ecologic validity of these tests and suggest directions for the development of intervention strategies for harm prevention.     

CongenitaI Polycystic Disease of the Brain: Report of an Unusual Case

Multiple congenital supratentorial intracerebral cysts occurred in a newborn infant. The cysts, of varying size, content and lining, occupied the cerebral hemispheres. They formed a mosaic pattern on CT scan and left no trace of a recognisable ventricular system. Multiple surgical procedures were performed during the first year of life, and at one year the child was very well and asymptomatic, with two functioning shunts.     

Sonographic changes following splenectomy for portal hypertension in Schistosoma mansoni.

Eleven patients with portal hypertension due to infection with Schistosoma mansoni underwent splenectomy and devascularization operations. The patients were examined with ultrasound once preoperatively and twice postoperatively over a period of about 6 months. Following surgery there was significant and sequential reduction in the diameter of the portal vein at the hilum and the splenic vein at the pancreas. The liver lengths and index of liver size did not change significantly. No changes in the degree of periportal fibrosis could be detected.     

Use of Antibodies in Lymphocyte Secretions for Detection of Subclinical Tuberculosis Infection in Asymptomatic Contacts

We have previously demonstrated that Mycobacterium bovis BCG-specific immunoglobulin G antibodies in lymphocyte secretions (ALS) can be employed as a marker for active tuberculosis (TB). We aimed to determine whether the ALS method allows detection of subclinical TB infection in asymptomatic individuals. A prospective study of family contacts (FCs) of patients with active TB and healthy controls was performed. Thirteen of 42 FCs had high ALS responses, including 6 FCs who subsequently developed active TB. No correlation was observed between the tuberculin skin test and the ALS responses in the FCs (r = 0.1, P = 0.23). Among patients with active TB, BCG-specific ALS responses steadily declined from the time of diagnosis through 6 months following antimycobacterial chemotherapy (P = 0.001). The ALS assay enabled detection of infection in exposed symptom-free contacts, who are at greater risk for developing active TB. The method may also allow discrimination between effective treatment of active infection and suboptimal response to therapy.     

Spinal stenosis due to posterior syndesmophytes in a patient with seronegative spondyloarthropathy

Summary Spinal involvement in spondyloarthropathy is characterized by inflammation concentrated at the site of bony insertion of ligaments and bones. These inflammatory sites show a peculiar tendency towards prominent fibrosis, ossification and new bone formation (syndesmophytes). The syndesmophytes arise either at the margins of intervertebral disc and these are called marginal syndesmophytes as in ankylosing spondylitis, or from the vertebral bodies beyond their corners and are called nonmarginal syndesmophytes as in psoriatic arthritis and Reiter's syndrome (1,2). In some references and in the European literature, the term syndesmophyte is usually reserved for the vertical ossification that bridges two adjacent vertebrae in ankylosing spondylitis (3) Syndesmophytes predominate on the anterior and lateral aspect of the spine (1–3). We report a patient with undifferentiated spondyloarthropathy with posterior syndesmophytes resulting in symptomatic spinal stenosis.     

A clinico-pathological study of Neogynon as a new oral contraceptive steroid

Clinical experience, and a pathology study, of 184 women on Neogynon (.25 mg d-norgestrel and .05 mg of 17-ethinyl estradiol, micro 20) was assessed for a total of 3129 cycles. 53 women were nursing babies before use of the pill, and 44 continued to do so throughout pill usage. Endometrial biopsies were taken premenstrually, during the period of full hormonal effect, for 40 cases before and then 6-12 months after initiation of pill usage; biopsies were studied for effect of the combined steroid on the building up of endometrium. The combination pill was 100% effective, with no failures. 23 cases (12.5%) failed to continue through the 18th cycle. 4 cases stopped after the 2nd cycle and 6 more after the 4th; the remaining stopped after the 12th cycle. No change in menstrual pattern was noticed in 136 (73.9%) of the cases; 14 presented with menorrhagia and endometrial biopsy of one of these showed regressive and mixed endometrial changes. 2 cases of intermenstrual spotting were reported. Hypomenorrhea was reported in 16 cases. Side effects were generally effects on the central nervous system: 7 cases of headache and dizziness, 7 cases of mild depression, and 3 cases of sexual anorexia. No gastrointestinal side effects were reported. 44 cases (of 53) continued lactation, and 9 noticed a progressive decrease in the amount of milk produced. 8 cases gained weight and 13 lost, 2 enough to quit using the pills. Hair loss was a noticeable complaint in 5 cases. Endometrial biopsies revealed grades of arrest of endometrial development. 85% showed a resting endometrial pattern, whereas 15% were atrophic. Endometrial response was rather irregular and mainly of the mixed type in 90% of the cases and about 10% were proliferative.